Amygdala modulation during delivered and undelivered visceral pressure

Berman, Steven M.; Mayer, Emeran A.; Suyenobu, Brandall Y.; Gordon, Wilbert; Chang, Lin; Naliboff, Bruce D.

doi:10.1016/s0016-5085(03)83445-5

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“…Because brain physiology uses layered inhibition and disinhibition of distributed functional networks, it is reasonable that increased activity in one region can produce hyperpolarization leading to decreased activity in other regions. Although BOLD decreases could also be artifacts of activations, because of an initial signal dip that can be maximal in the spatial surround of a focal activation, spatial dissociation of activations from deactivations, as we have recently demonstrated in multiple structures (5,6,8), argues against the widespread acceptance of this explanation. It has been proposed that the rCBF decreases during intense pain, which would also be expected to produce BOLD decreases, could be due to increased sympathetic activity or hyperventilation (12).…”

Section: Possible Mechanisms Underlying Bold Signal Decreasesmentioning

confidence: 82%

“…Because examination of this aim using standard random-effects imaging analysis may obscure the presence of activations and deactivations occurring within the same region and perhaps differing in their proportion across conditions or sex, we also report an exploratory, hypothesis-generating analysis looking at individual subject level data on activations, deactivations, and their ratio within each region of interest. Parts of these results have been reported in abstract form (5).…”

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confidence: 94%

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Sex differences in regional brain response to aversive pelvic visceral stimuli

Berman

Naliboff²,

Suyenobu³

et al. 2006

American Journal of Physiology-Regulatory, Integrative and Comp

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To explore sex differences in the response of seven brain regions to an aversive pelvic visceral stimulus, functional magnetic resonance images were acquired from 13 healthy adults (6 women) during 15 s of cued rectal distension at two pressures: 25 mmHg (uncomfortable), and 45 mmHg (mild pain), as well as during an expectation condition (no distension). Randomeffects analyses combining subject data voxelwise found 45-mmHg pressure significantly activated the insular and anterior cingulate cortices in both sexes. In men only, the left thalamus and ventral striatum were also activated. Although all activations appeared more extensive in men, no sex difference attained significance. To explore the presence of deactivations, which are generally cancelled by more numerous activations when subjects are combined for each voxel, the number of activated voxels, number of deactivated voxels, and ratio of deactivated voxels to total voxels affected were assessed via randomeffects, mixed-model analyses combining subject data at the region level. Greater insula activation in men compared with women was seen during the expectation condition and during the 25-mmHg distension. Greater deactivations in women were seen in the amygdala (25-mmHg distension) and midcingulate (45-mmHg distension). Women had a significantly higher proportion of deactivated voxels than men in all four subcortical structures during 25-mmHg distension. Greater familiarity of females with physiological pelvic visceral discomfort may have enhanced brain systems that dampen arousal networks during lower levels of discomfort. functional magnetic resonance imaging; brain imaging; pain CONSIDERABLE EPIDEMIOLOGICAL and experimental evidence suggests that men and women respond to pain differently in terms of perceptual and autonomic nervous system responses. Epidemiological data indicate that compared with men, women are overrepresented in many, but not all, chronic pain disorders, including fibromyalgia, migraine, interstitial cystitis, and functional gastrointestinal disorders, such as irritable bowel syndrome (IBS) (59). For example, women are more likely to suffer from IBS, develop the so-called postinfectious IBS, and develop comorbidities such as fibromyalgia or interstitial cystitis (36). A variety of mechanisms have been proposed to explain these sex differences, including differences in the response of the central nervous system to pelvic visceral stimuli.Despite the similarity between sex differences in somatic and visceral pain prevalence in epidemiological and diseaserelated studies, the results of experimental pain studies with the two types of pain stimuli differ. Consistent with the epidemiological data, women have greater sensitivity and less tolerance to somatic pain stimuli (52). In contrast, the majority of studies using controlled rectal balloon distension (a frequently used pelvic visceral pain stimulus), to date, have not shown significant sex-related differences in pain or discomfort thresholds in either controls or IBS patients (26,37,42...

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Section: Possible Mechanisms Underlying Bold Signal Decreasesmentioning

confidence: 82%

mentioning

confidence: 94%